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What does a driving assessment look at?
A driving assessment looks at everything that could affect your driving ability. This includes changes to your body, memory and thinking, as well as other things like fatigue and emotional changes.
Your vision will be checked after your stroke, but sight problems can emerge over time. If you have a driving assessment, your vision will be screened, and you may be sent for a sight test if there are any concerns.
They will check for different types of vision loss including:
Loss of visual field (also known as hemianopia)
This is when part of your vision is missing. It can be to one side or in the middle, and it usually affects the same side on both eyes. Some people are aware of the missing area which can appear as a blank space. It can improve over time and some people will recover completely.
Visual inattention (also known as visual neglect or spatial inattention)
This means you lack awareness of things to one side. Your eyes work normally, but your brain does not interpret all of the signals from the eyes. You will not be aware of a gap in your vision, but you or other people might notice that you bump into things, ignore food to one side of your plate, or have trouble finding your way around. An orthoptist or occupational therapist can assess you for inattention.
Visual inattention can improve after a stroke. If you have long-term inattention, it will usually stop you from driving. Some people will be able to drive after a specialist assessment.
This is most common soon after a stroke and can improve over time. This might affect night driving when there is glare from headlights or reflections from wet road surfaces. If you need to wear dark glasses during the day, you need to ensure that they allow in enough light for you to see clearly.
More about vision
If you become aware of changes to your vision at any time, ask an optometrist or GP for help.
Stroke can affect your vision in many ways. Find out more about vision problems here.
The DVLA website provides details of ‘exceptional case’ rules, which may enable some individuals who lost their licence due to certain visual field defects to drive again, if they meet a set of strict criteria and pass a driving assessment. See the DVLA guidance here.
An assessment will check if you have the strength and coordination to use the vehicle controls. This can be affected by:
- Weakness or paralysis in your arms, hands, legs or feet.
- Pain, stiffness and muscle spasms.
- Reduced coordination.
- Numbness in hands and feet.
- Not being aware where your arms, hands, legs or feet are in space (proprioceptive problems).
If you cannot use standard vehicle controls, vehicles can be adapted to let you drive with one hand, or without using your feet.
Problems with memory and thinking (cognitive effects)
Driving involves many thinking skills. These include:
- Attention: being able to pay attention to everything happening on the road, and switch your attention quickly from one thing to another.
- Decision-making and quick thinking: being able to process information and react quickly.
- Spatial and perception skills: recognising objects, judging distances and your position in space, judging speed and time.
When you are driving, your brain has to process information about other cars and the road very quickly. Having difficulties with thinking, or reduced processing speeds, can affect your ability to respond quickly and accurately.
Cognitive decline or dementia
If you have been diagnosed with cognitive decline or dementia you will need to tell the DVLA/DVA.
Alertness and fatigue
Some things can affect your alertness and reaction times. These include:
After a stroke, most people have some level of fatigue. This could make it hard to stay focused or stay awake at the wheel. Be aware of your tiredness levels when driving. You might need to avoid long journeys, or plan your travel at times when you have the most energy.
Confusion and concentration problems
Many people experience some confusion or have concentration problems after a stroke. This often gets better in the first few weeks, but you should be aware of any changes to your alertness and ask your stroke team or GP for advice.
Some medications can cause sleepiness or fatigue, or loss of short-term memory. Ask your pharmacist for more information on your medication and its side-effects. If you are taking something that can cause sleepiness, it may be possible to swap to another type.
Do I have to surrender (send back) my licence?
Not always. Telling the DVLA/DVA about a medical condition does not mean you have to return your licence unless they tell you to. But you will need to surrender your licence if a medical professional tells you to stop driving for three months or more.
I drive a bus or lorry. Do I have to send my licence back?
Yes, you will need to return your licence. You should tell the DVLA/DVA about your stroke as soon as you can. They will write to you, explaining what you should do next, which includes returning your licence. The DVLA will ask for permission to contact medical professionals about your stroke. If they do not get a reply, your licence may be revoked. When you apply to re-licence, the DVLA may request medical reports and tests or a driving assessment.
You can re-apply for a car licence while you are not able to drive a bus or lorry.
Is it better to surrender my licence voluntarily, rather than wait for it to be revoked?
It can be quicker and easier to re-apply for your licence if you returned it voluntarily. After you re-apply, you will be able to drive while waiting to hear back from the DVLA/DVA, provided you meet the criteria of Section 88 of the Road Traffic Act. You will need confirmation that DVLA have received a valid application from you. You must meet the medical standards for driving, and there should not be any other legal reason you cannot drive. You might need individual advice or a driving assessment to check you are safe to start driving again.
Should I ask my GP for permission to drive?
If you already know you are safe and legal to drive again, you can go ahead without speaking to a health professional. The role of GPs and other health professionals is to give you individual advice about your stroke and how it affects your driving.
Legal decisions about your licence are made by the DVLA/DVA. They sometimes use recommendations from a medical check to help them make the decision.
Will I need a medical test or driving assessment?
Tests and assessments can include:
- The DVLA/DVA might ask you to have a driving assessment or medical tests.
- A health professional might advise you to have an assessment or tests.
- You can seek an assessment yourself to find out how your driving has been affected by stroke.
- You might need to request medical or sight tests to meet the requirements for your licence.
I had a head injury or traumatic brain injury (TBI). Do the same rules apply for driving?
If you had a brain haemorrhage due to the injury, you must tell the DVLA/DVA. How a head injury affects your driving depends on the type of injury and the treatment you had, as well as the effects of the injury. It’s a good idea to get individual advice and support. The DVLA medical conditions phone line can help, and you can also contact a driving assessment centre for individual advice.